SMQT Resident Rights and Dignity 5 — Questions and Answers
Question 1: A resident with moderate dementia is observed by a surveyor to be wearing soiled clothing at midday, with staff walking past without intervening. This most directly suggests a deficiency in:
- Infection control practices
- Resident dignity and personal hygiene care (Correct answer)
- Staffing ratios
- Restraint use policies
Correct answer: Resident dignity and personal hygiene care
Allowing a resident to remain in soiled clothing indicates a failure to provide care that maintains dignity and basic hygiene, a direct violation of resident rights.
Question 2: Under the SMQT framework, which resident rights tag is associated with a resident's right to be free from verbal, mental, sexual, and physical abuse?
- F550
- F600 (Correct answer)
- F725
- F812
Correct answer: F600
F600 addresses the right to be free from abuse, neglect, and exploitation, a foundational resident rights protection under federal regulations.
Question 3: A surveyor finds that a nursing facility charges a Medicaid resident a fee for an activity that is considered a basic service under Medicaid. This finding relates to which resident right?
- Right to participate in care planning
- Right to be fully informed of services and charges, including the right not to be improperly charged (Correct answer)
- Right to manage personal finances
- Right to refuse treatment
Correct answer: Right to be fully informed of services and charges, including the right not to be improperly charged
Residents must be fully informed of services and applicable charges, and facilities cannot bill Medicaid residents for services already covered under Medicaid.
Question 4: When a resident's representative (not the resident) is the primary decision-maker, the surveyor should verify that:
- The facility communicates only with the representative and not the resident
- The resident is still involved in care decisions to the extent of their ability and desire (Correct answer)
- A representative's authority supersedes all resident preferences without exception
- The representative's decisions are reviewed monthly by the medical director
Correct answer: The resident is still involved in care decisions to the extent of their ability and desire
Even when a representative is involved, residents must be included in care decisions to the extent they are able and wish to participate.
Question 5: A facility's policy requires all residents to attend morning exercises. A resident refuses to attend, citing their right to choose their activities. The facility:
- May require attendance since group activities support clinical goals
- Must honor the resident's right to choose their schedule and activities (Correct answer)
- Can document the refusal and bill the family for the missed session
- Should place the resident in a supervision room during the exercise period
Correct answer: Must honor the resident's right to choose their schedule and activities
Residents have the right to choose their activities and daily schedule, and mandatory participation in activities violates this right.
Question 6: During a survey, a resident tells the surveyor they are afraid to complain about care because they fear retaliation from staff. This concern relates most directly to the resident's right to:
- Refuse treatment
- Voice grievances without discrimination or reprisal (Correct answer)
- Access their medical records
- Receive visitors of their choice
Correct answer: Voice grievances without discrimination or reprisal
Residents have the explicit right to voice grievances without fear of discrimination, interference, coercion, or reprisal from the facility or its staff.
Question 7: A surveyor is reviewing a facility's advance directive policies. Which finding would indicate a deficiency in honoring resident rights?
- The facility asks about advance directives at admission
- The facility documents the resident's advance directive status in the medical record
- The facility refuses to honor a resident's DNR order because it conflicts with staff values (Correct answer)
- The facility provides information about advance directives to all residents
Correct answer: The facility refuses to honor a resident's DNR order because it conflicts with staff values
Facilities must honor valid advance directives including DNR orders; staff personal beliefs cannot override a resident's legally executed directive.
SMQT Resident Rights and Dignity 5
A resident with moderate dementia is observed by a surveyor to be wearing soiled clothing at midday, with staff walking past without intervening.
This most directly suggests a deficiency in: